The person who has had amputation of a lower limb and who wears a prosthesis subjects the skin of his stump to multiple insults. Mechanical trauma, if acute, may cause edema, erythema, denudation of epithelium, or ulceration; if chronic, it may cause lichenification, callus formation, and hyperpigmentation. Acute contact dermatitis caused by primary irritants or allergenic substances may result in edema, erythema, and vesiculation; chronic contact dermatitis produces scaling, eczematization, lichenification, and hyperpigmentation. Increased warmth and moisture may cause localized anhidrosis,1 miliaria, and maceration. Secondary bacterial infection may follow any of the above conditions. The prosthetic bucket and corset enclose the stump tightly and cause pressure and friction from the piston motion in walking. Warmth and moisture result from inadequate ventilation of the skin, which is covered by impermeable material. The almost universal use of the woolen stump sock, except by amputees who wear suction sockets, may cause irritation.
Schamberg IL. DERMATITIS OF LOWER LIMB AMPUTATION STUMP. JAMA. 1952;150(17):1653–1655. doi:10.1001/jama.1952.03680170007002
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